From the Departments of †Urology, ‡Biomedical

Perhaps one of the most exciting and revolutionary sci-entific discoveries of the past 3 decades has been the de-velopment of in vitro fertilization (IVF) to treat human infertility. It is impossible to quantify its effect on nu-merous families since the first IVF birth in 1978 in Old-ham, England (Steptoe and Edwards, 1978). With increas-ing clinical utilization of assisted reproductive technolo-gies (ART), scientists and clinicians gain insights into ba-sic gamete and embryo biology and translate that knowledge into improving the process of IVF. Critical analyses of individual steps have improved outcomes. At-tention to sperm processing and isolation to increase re-covery of motile sperm and reduce sperm damage has improved fertilization rates and embryo development (Mortimer, 1994). Use of intracytoplasmic sperm injec-tion (ICSI) has allowed fertilization even in severe cases of compromised sperm quality or number (Bonduelle et al, 1999). Finally, refinement of embryo culture has led to improved in vitro embryo development and implanta-tion rates (Gardner and Lane, 1998; Pool, 2002). Most scientific attention, however, has focused on methodolo-gies rather than technology development and equipment. Semen is still processed in test tubes regardless of tech-nique, sperm are physically placed with oocytes after pro-cessing, and fertilization and embryo culture occur in cul-ture dishes, test tubes, or both with relatively large vol